Dental Reimbursement Rates

In an industry where you are both the care provider and business owner, dentists must constantly be reviewing how they provide services, and how they get paid for those services.In many cases, dentists participate in a PPO (preferred provider organization), but sometimes these affiliations could be affecting your ability to grow your bottom line because the PPO dental plan fee doesn’t offer adequate reimbursement. If you find that your practice is not growing, or your profits have stalled or declined, it may be time to consider bringing in Everest Advocates to develop a plan for negotiating a better fee structure.

Should You Participate in a PPO?

The decision whether to participate in a PPO is based on several factors, but most importantly the volume of patients you get as a percentage of your overall patient base from participating in the PPO, and the services you will be able to provide as a participating member of the PPO. In cases where you feel like you are unable to provide the best care because reimbursement rates are too low, or the insurance doesn’t cover the procedures that you think are most beneficial, you may opt out of the dental PPO. In other cases, you may just need to negotiate an increase in the PPO dental plan fee so you can get reimbursed at an adequate level and still provide the services to your patients.

At Everest Advocates, we can help you review your current PPO participation and contracts, and identify areas where you can try to get a better PPO reimbursement.

How Can Better PPO Reimbursement Rates Improve Your Practice?

When it comes to working with insurance companies as part of a PPO, many dentists think their hands are tied with the fee schedules offered. When you work with Everest Advocates to improve your PPO reimbursement, you will see many ways it can benefit your dental practice. You may be able to reduce the volume of patients you accept so you can spend more one-on-one time with each patient instead of trying to hurry them through. In addition, you may be able to offer procedures that are beneficial to patients but you have not been able to provide because the PPO dental plan fee did not pay enough to make it worthwhile, or charge more competitive fees overall because reimbursement rates better reflect your actual costs.

If you want to learn more about how Everest Advocates can help you negotiate higher PPO reimbursements, increasing your PPO dental plan fees, call toll-free 800-518-1279, contact our office at 801-657-4498 or use our simple online form to request more information.